Background: Cardiovascular diseases (CVDs) are the leading global disease burden, with alcohol consumption closely linked to their occurrence. This study analyzes data from the Global Burden of Disease Study 2021 (GBD 2021) to assess the distribution and trends of high alcohol use-related CVD from 1990 to 2021 across global, regional, and national levels.Materials and methods: We used the data from the GBD 2021 to conduct stratification by region, country, gender, age, SDI, and disease type in terms of the number of deaths, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), age-standardized rate of DALYs (ASDR), years lived with disability (YLDs), age-standardized rate of YLDs, years of life lost (YLLs), and age-standardized rate of YLLs to comprehensively assess the burden of high alcohol use-related CVD from 1990 to 2021. All statistical analyses in this study were performed using R statistical software (version 4.1.2).Results: Between 1990 and 2021, global deaths, DALYs, YLDs, and YLLs attributable to high alcohol use-related CVD showed notable variation. By 2021, global deaths had doubled compared to 1990, while ASMR, ASDR, age-standardized YLD rate, and YLL rate all declined. Eastern Europe had the highest rates in 2021. Males consistently had higher ASMR, ASDR, YLD, and YLL rates compared to females, with the highest number of deaths occurring in the 70–74 age group, and the 65–69 age group showing the highest DALYs, YLDs, and YLLs. These rates increased with age. Stroke was the most common high alcohol use-related CVD, while ischemic heart disease (IHD) was the least common.Conclusion: Between 1990 and 2021, the overall burden of high alcohol use-related CVD declined globally, though some regions experienced an increase. This highlights the need for continued public health efforts, particularly targeting high-risk regions and populations, to mitigate the impact of alcohol on cardiovascular health.

Background: Despite significant reductions in in-stent restenosis (ISR) incidence with the adoption of drug-eluting stents (DES) over bare metal stents (BMS), ISR remains an unresolved issue in the DES era. The risk factors associated with DES-ISR have not been thoroughly analyzed. This meta-analysis aims to identify the key factors and quantify their impact on DES-ISR. Methods: We conducted comprehensive literature searches in PubMed, EMBASE, Cochrane, and Web of Science up to 28 February 2023, to identify studies reporting risk factors for DES-ISR. Meta-analysis was performed on risk factors reported in two or more studies to determine their overall effect sizes. Results: From 4357 articles screened, 17 studies were included in our analysis, evaluating twenty-four risk factors for DES-ISR through meta-analysis. The pooled incidence of DES-ISR was approximately 13%, and significant associations were found with seven risk factors. Ranked risk factors included diabetes mellitus (odds ratio [OR]: 1.46; 95% confidence interval [CI]: 1.14–1.87), stent length (OR: 1.026; 95% CI: 1.003–1.050), number of stents (OR: 1.62; 95% CI: 1.11–2.37), involvement of the left anterior descending artery (OR: 1.56; 95% CI: 1.25–1.94), lesion length (OR: 1.016; 95% CI: 1.008–1.024), medical history of myocardial infarction (OR: 1.79; 95% CI: 1.12–2.86) and previous percutaneous coronary intervention (OR: 1.97; 95% CI: 1.53–2.55). Conversely, a higher left ventricular ejection fraction was identified as a protective factor (OR: 0.985; 95% CI: 0.972–0.997). Conclusions: Despite advancements in stent technology, the incidence of ISR remains a significant clinical challenge. Our findings indicate that patient characteristics, lesion specifics, stent types, and procedural factors all contribute to DES-ISR development. Proactive strategies for early identification and management of these risk factors are essential to minimize the risk of ISR following DES interventions. The PROSPERO Registration: CRD42023427398, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=427398.

Background and objective: Cardiac rehabilitation (CR) has been demonstrated to improve outcomes in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). However, the optimal CR initiation time and duration remain to be determined. This study aimed to explore the impact of the time factors on the CR outcomes in AMI patients who received PCI by the method of meta-regression analysis. Methods: We searched five databases (PubMed, Embase, Cochrane Library, Web of Science and Google scholar) up to October 31, 2023. Meta-regression analysis was utilized to explore the impact of the time factors on the effect sizes. Subgroups with more than 3 studies were used for meta-regression analysis. Results: Our analysis included 16 studies and a total of 1810 patients. The meta-regression analysis revealed that the initiation time and duration of CR had no significant impact on the occurrence of arrhythmia, coronary artery restenosis and angina pectoris. The initiation time and duration of CR also had no significant impact on the changes in left ventricular ejection fraction (LVEF, starting time: estimate = 0.160, p = 0.130; intervention time: estimate = 0.017, p = 0.149), left ventricular end-diastolic volume (LVEDV, starting time: estimate = − 0.191, p = 0.732; intervention time: estimate = − 0.033, p = 0.160), left ventricular end-systolic volume (LVESV, starting time: estimate = − 0.301, p = 0.464; intervention time: estimate = 0.015, p = 0.368) and 6-minute walk test (6MWT, starting time: estimate = − 0.108, p = 0.467; intervention time: estimate = 0.019, p = 0.116). Conclusion: Implementation of CR following PCI in patients with AMI is beneficial. However, in AMI patients, there is no significant difference in the improvement of CR outcomes based on different CR starting times within 1 month after PCI or different durations of the CR programs. It indicates that it is feasible for patients with AMI to commence CR within 1 month after PCI and continue long-term CR, but the time factors which impact CR are intricate and further clinical research is still needed to determine the optimal initiation time and duration of CR.

Background: Guanxinning tablet (GXNT), a Chinese patent medicine, is composed of salvia miltiorrhiza bunge and ligusticum striatum DC, which may play the role of endothelial protection through many pathways. We aimed to explore the molecular mechanisms of GXNT against atherosclerosis (AS) through network pharmacology and molecular docking verification. Methods: The active ingredients and their potential targets of GXNT were obtained in traditional Chinese medicine systems pharmacology database and analysis platform and bioinformatics analysis tool for molecular mechanism of traditional Chinese medicine databases. DrugBank, TTD, DisGeNET, OMIM, and GeneCards databases were used to screen the targets of AS. The intersection targets gene ontology and Kyoto encyclopedia of genes and genomes enrichment analysis were performed in DAVID database. GXNT-AS protein-protein interaction network, ingredient-target network and herb-target-pathway network were constructed by Cytoscape. Finally, we used AutoDock for molecular docking. Results: We screened 65 active ingredients of GXNT and 70 GXNT-AS intersection targets. The key targets of protein-protein interaction network were AKT1, JUN, STAT3, TNF, TP53, IL6, EGFR, MAPK14, RELA, and CASP3. The Kyoto encyclopedia of genes and genomes pathway enrichment analysis showed that pathways in cancer, lipid and atherosclerosis, and PI3K-Akt signaling pathway were the main pathways. The ingredient-target network showed that the key ingredients were luteolin, tanshinone IIA, myricanone, dihydrotanshinlactone, dan-shexinkum d, 2-isopropyl-8-methylphenanthrene-3,4-dione, miltionone I, deoxyneocryptotanshinone, Isotanshinone II and 4-methylenemiltirone. The results of molecular docking showed that tanshinone IIA, dihydrotanshinlactone, dan-shexinkum d, 2-isopropyl-8-methylphenanthrene-3,4-dione, miltionone I, deoxyneocryptotanshinone, Isotanshinone II and 4-methylenemiltirone all had good binding interactions with AKT1, EGFR and MAPK14. Conclusion: The results of network pharmacology and molecular docking showed that the multiple ingredients within GXNT may confer protective effects on the vascular endothelium against AS through multitarget and multichannel mechanisms. AKT1, EGFR and MAPK14 were the core potential targets of GXNT against AS.

Objective: To deeply analyze the epidemiological characteristics of the disease burden of hypertension and its related damages among adolescents and young adults aged 15–39 globally from 1990 to 2021, and predict the trends until 2050, providing key evidence for formulating global public health strategies. Methods: The research data were derived from the Global Burden of Disease (GBD) 2021 database. The epidemiological trends of hypertension were systematically analyzed based on dimensions such as country/region, age, gender, and Socio-demographic Index (SDI). The age-standardization method was used to eliminate the influence of age-structure differences. Multiple statistical methods, including creating global maps, regional comparative analysis, and Joinpoint regression analysis, were employed to explore the distribution and change trends of the disease burden. The Bayesian Age to Period to Cohort (BAPC) model was utilized to predict future trends. Results: From 1990 to 2021, the absolute numbers of hypertension-related deaths, Disability-Adjusted Life Years (DALYs), and Years Lived with Disability (YLDs) increased significantly globally. The age-standardized mortality rate and DALY rate decreased to some extent, while the YLDs rate increased slightly. There were significant differences in the hypertension burden across different regions, countries, SDI regions, genders, and age groups. Predictions indicate that by 2050, the age-standardized mortality rate and DALY rate will generally show a downward trend, while the age-standardized YLDs rate will continue to rise. Conclusion: The burden of hypertension among the global population aged 15–39 is severe and complex, affected by multiple factors. This study provides important reference directions for global public health efforts. In the future, it is necessary to strengthen international cooperation and develop targeted prevention and control strategies to reduce the burden of hypertension-related diseases among adolescents and young adults and promote the healthy development of youth worldwide.

Objective: To evaluate the clinical efficacy and safety of Yingxin Pill (YXP) in patients with stable angina pectoris (SAP) and heart blood stasis obstruction syndrome. Methods: Sixty patients were randomly assigned to either the experimental group (YXP plus conventional Western medicine) or the control group (Shexiang Baoxin Pill [SBP] plus conventional Western medicine), with 30 patients in each group. Treatment lasted for 4 weeks. Outcomes included the Seattle Angina Questionnaire (SAQ), a Traditional Chinese Medicine (TCM) efficacy scale, blood lipid profiles, and inflammatory markers. The effective rate and incidence of adverse events were also compared. Results: After treatment, both groups showed significant improvements in SAQ scores, TCM efficacy scale scores, lipid profiles, and inflammatory markers compared to baseline (P < 0.05). There were no significant differences between the two groups in these outcomes, nor in the total effective rate or incidence of adverse events (P > 0.05). Conclusion: The addition of YXP to conventional therapy can improve symptoms, reduce blood lipid and inflammation levels, and is safe for patients with SAP and heart blood stasis obstruction syndrome. Clinical Trial Registration: https://itmctr.ccebtcm.org.cn/ , identifier ITMCTR2025000274.